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Doctors are urging caution after a 24-year-old UK man underwent emergency surgery when they discovered that his severely enlarged colon, filled with feces, had burst.

At the time of the surgery, the man had “reduced consciousness” and severe abdominal pain, as well as air trapped under his diaphragm, failing kidneys, and acidic blood.

In a short communication published this week in BMJ Case Reports, doctors elaborated on the man’s rare conditions, known as “megacolon” and “megarectum.” These are poorly understood ailments marked by enlarged entrails that aren’t caused by a physical blockage. Sometimes they can be explained by genetic abnormalities or other acquired conditions, such as diseases that affect intestinal motility or muscle and connective-tissue function. But in this case, the man seemed to have a chronic, idiopathic case, meaning there was no clear cause of the gargantuan guts.